Individual
MAUDESTA SCOTT CALEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4039 GATEWAY BLVD STE 201, GROVETOWN, GA 30813-3390
(706) 432-6866
Mailing address
1247 PARAMOUNT CT, HEPHZIBAH, GA 30815-4554
(478) 241-4349
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC010166
GA
Other
Enumeration date
07/25/2019
Last updated
07/01/2023
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